WebTPA Q3 Quarterly Newsletter
As renewal season approaches, thoughtful planning and early coordination are key to ensuring a successful Open Enrollment experience for your organization and employees.
In this quarter's newsletter, we're highlighting key areas to review as you prepare for the upcoming plan year. Our goal is to help you identify potential roadblocks early, coordinate with your vendors and internal teams, and stay on track for a seamless implementation.
In this quarter's newsletter, we're highlighting key areas to review as you prepare for the upcoming plan year. Our goal is to help you identify potential roadblocks early, coordinate with your vendors and internal teams, and stay on track for a seamless implementation.
A Message from Lisa Tranberg
Renewal Key Milestones & Dates
The 5 Questions Every Self-Funded Employer Should Ask Before Renewal
Enrollment Services Readiness
Compliance & Regulatory Updates
Upcoming Changes to Obstetric Billing Codes
Communitas: A New & Improved Online Experience
Celebrating This Quarter's Employee Milestones
Our Team in the Community
After more than 30 years in the insurance and benefits industry, I am still amazed by how quickly the end of summer arrives and renewal season begins. Some years it feels like a gentle breeze, while others can feel more like a hurricane. At WebTPA, our goal has been to make the renewal process as predictable, organized, and stress-free as possible for our clients and partners.
Over the past several years, we have made significant investments in improving the renewal experience. By establishing clearer timelines, communicating key milestones earlier, and providing greater visibility into expectations, we help employers and vendor partners stay ahead of important deadlines and avoid last-minute surprises. We have also intentionally moved certain due dates forward to create more time for review, accuracy, and collaboration, reducing the risk of errors that can occur when everyone is rushing to the finish line.
I am incredibly proud of the results we have achieved and the dedicated WebTPA team that makes it possible. While we have removed much of the chaos, confusion, and urgency that often accompany renewal season, we remain committed to continuous improvement. Each year, we bring together all stakeholders to review what worked well, identify opportunities to improve, and apply those lessons to the next renewal cycle.
As we begin this year's renewal season, I encourage you to partner closely with our outstanding Account Management team, follow the established process, and stay focused on key milestones and deadlines. Together, we can ensure a smooth and successful renewal experience for everyone involved.
Renewal Key Milestones & Dates
Below are recent and upcoming renewal milestones to help keep us on track for a smooth renewal and open enrollment. Click here to view the full Renewal Key Milestones & Dates. Contact your Account Executive with questions.
| Milestone | Date |
| Final Renewal Changes | 08/15/2026 |
| Signed SBC Notices | 08/26/2026 |
| Signed Renewal Statement of Work (RSOW), formerly PCN | 08/26/2026 |
| Signed Compliance Checklist Submitted to WebTPA | 09/11/2026 |
| Signed Benefit Grids Submitted to WebTPA | 09/30/2026 |
The 5 Questions Every Self-Funded Employer Should Ask Their Account Executive Before Renewal
The decisions made at renewal can have a lasting impact on both your healthcare spend and employee experience, making it essential to ask the right questions before moving forward.
• What are the biggest factors driving our healthcare costs this year?
• What opportunities do we have to lower costs without reducing benefits?
• Are employees using the benefits available to them?
• How are we performing compared to similar employers?
• What should we change next year to improve member experience and plan financial performance?
As we begin preparing for the upcoming renewal season, now is the ideal time to review key operational and implementation considerations that can impact Open Enrollment success. To help facilitate planning and avoid last-minute challenges, we encourage you to review the following questions with your internal teams and vendors. These topics can have a significant impact on enrollment processing, ID card production, system configuration, and overall implementation readiness.
- Are there any anticipated changes associated with your EDI vendor that will require additional testing?
- Are any updates planned to the physical ID card design, content or branding this year?
- Based on the planned changes, do you anticipate a full ID card reprint, or will card production be limited to new enrollments and members with qualifying changes?
- Would it be feasible to deliver the Open Enrollment file closer to November 13th to support implementation and production timeliness?
- Are we on track to finalize and deliver Cobra rates by October 1st to support timely configuration and validation?
Upcoming Change to NSA Negotiation and IDR Administration
Effective January 1, 2027, WebTPA will transition administration of NSA open negotiations and IDR activities to The Phia Group, providing clients access to specialized reimbursement and dispute management expertise. Your Account Executive is available to discuss questions and help determine the approach that best meets your plan’s needs.
For more information regarding the transition and a detailed overview of how NSA open negotiations and IDR activities will be managed moving forward, click the link below.
SOC 2 Audit Underway
As part of our commitment to protecting client and member data, we are undergoing our first SOC 2 audit, an independent third-party assessment of our security and operational controls. The audit will evaluate our practices for security, availability, and confidentiality, providing objective validation that our systems and processes are designed to safeguard sensitive information and operate reliably. This milestone reflects our ongoing investment in security, transparency, and the trust our clients place in us every day.
Embrace the Digital Future: Paperless Communications
As the healthcare industry continues to move toward digital-first communications, recent CMS initiatives, including the CLIA program's transition to fully electronic delivery effective March 1, 2026, reflect the growing shift away from paper-based processes. At WebTPA, we offer paperless Explanation of Benefits (EOBs) and digital ID cards, providing members with secure, convenient access to their information while reducing administrative costs and environmental impact. Many of our clients have already adopted these solutions, and for those that have not, renewal season is an ideal time to consider making the transition as the industry continues to move toward a more digital future.Member Communications During Open Enrollment & Beyond
Open Enrollment is more than a benefits enrollment event. It's an opportunity to educate members, drive engagement, and encourage healthier outcomes throughout the year. WebTPA can support your communication strategy by delivering timely, targeted messages across multiple channels. From portal pop-up notifications promoting plan-related events to campaigns designed to increase preventive care utilization, we help ensure important information reaches your members when it matters most. Communication options include email campaigns, postcards, online messaging, and flyers, allowing you to tailor outreach to your population and maximize member awareness and participation.
Vaccine Executive Order Update for Preventive Services
Availity Enhancements for Providers
Providers completed over 4.9 million self-service transactions through Availity in Q2 2026, reducing administrative workload and enabling providers to spend more time focused on patient care.
Coming Soon – WebTPA will be implementing Availity’s “Message The Payer” service which will allow providers to communicate directly with WebTPA Customer Service through a secure messaging application within the Availity Provider Portal. This will create an additional channel for providers to communicate with WebTPA and receive the information they need to support their patients. This new service feature is scheduled to be released in Fall 2026.
Below are our claims insights incurred 1/1/2026 - 6/30/2026. Talk to your account executive to see how these trends have impacted your population.
- Cancer remains a leading cost driver, with continued upward trends for breast, prostate, and cervical cancer.
- Preventative care utilization is increasing, particularly across screenings and wellness visits for breast, cervical and colon cancer. Being the #2 highest paid diagnostic group, this is a positive indicator that we are seeing an increase.
- Mental Health is an emerging area to watch, ranking 8th in total paid spend but showing the largest increase in both spend and utilization
- Gastrointestinal, musculoskeletal, and cardiac are showing increases in higher-acuity cases with spend growth outpacing utilization.
Upcoming Changes to Obstetric Billing Codes
Beginning January 1, 2027, significant changes to obstetric billing codes are expected to take effect. The new coding structure will move away from the traditional bundled approach to maternity care and toward more detailed reporting of prenatal, delivery, and postpartum services. Supporters believe the updated methodology will better reflect the complexity and variation of maternity care, while employers, health plans, and industry experts continue to evaluate the potential impact on healthcare costs and billing patterns
Communitas has received numerous questions regarding these changes and is actively monitoring the implementation. While the long-term financial impact remains uncertain, we recognize the importance of providing visibility into any changes affecting maternity care utilization and costs. As these new codes are adopted, we will ensure our reporting and analytics continue to provide the transparency and insight needed to help clients understand potential impacts to their benefit plans and identify emerging trends.
We're pleased to announce the launch of our sister company's new website!
Communitas brings clarity and compassion to the healthcare landscape. As our clinical arm, Communitas provides many of WebTPA's clients with impactful services that protect plan dollars while prioritizing the health of plan members.
We encourage you to explore the updated site and learn more about Communitas services, the populations they support, and the exceptional team behind their work.
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Zeneen Bowen - Ginger McMurtray - Takiyah Wortham - Deborah Rose - Deanna Gillette - Melissa Tibbs - Makenzie Lechtenberg - Miranda Mreen - Allison Anderson - Holly Colangelo - Tracy Carman - Shannon Junek - Belynda Thomas - Keri Kephart - Melinda Redfearn - Cindy Solomon - Genevieve Ruelas - Michelle Cox - Karen Allen
15+
Rhonda Lawrence - Tamekia Lawrence - Jack Lyon - Lizzie Taylor - Tamara Davis - Cindy Whitaker - Victoria Sutton - Julie Bush
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Sheila Weinbrecht - Debra Hill - Karla Johnson - Gina Palmesino - Shanell Wyatt-Owens - Anthony Lawless - Mickie Sykes - Amy Phillips - Shantel Thomas - Sandra Terrazas - Joe Ortiz - Cathryn Barnes - Kayla Fenner - Christine Burke - Rosalinda Rangel - Trina Richards - Kelly Jones - Steven Guevara - Sharon Thomas - Courtney Benton
Our Team in the Community
Through this year’s Summer of Service, WebTPA employees and their families joined together to support organizations serving important needs across our communities. In total, 190 participants contributed 332 volunteer hours, helping extend care, support, and practical assistance to individuals and families in need. We are grateful for the opportunity to give back in meaningful ways and to continue living out our commitment to service.
